Objectives Intermediate care services have been introduced to help mitigate unnecessary hospital demand and premature placement in long-term residential care. Many patients are elderly and/or with complex comorbidities, but little consideration has been given to the palliative care needs of patients referred to intermediate care services. The objective of this study is to determine the proportion of patients referred to a community-based intermediate care team who died during care and up to 24 months after discharge and so to help inform the development of supportive and palliative care in this setting.
Methods A retrospective cohort study of all 4770 adult patients referred to Northamptonshire Intermediate Care Team (ICT) between 11 April 2010 and 10 April 2011.
Results Of 4770 patients referred, 60% were 75 years or older and 32% were 85 years of age or older. 4.0% of patients died during their ICT stay and 11% within 30 days of discharge. At the end of 12 months, 25% of the patients had died, increasing to 32% before the end of the second year. About 34% of all deaths occurred during the ICT stay or within 30 days of discharge, and a further 46% by the end of the first year. Male gender and higher age were associated with greater likelihood of death.
Conclusions It is important for ICT clinicians to consider immediate and longer-term palliative care needs among patients referred to ICTs. Care models involving ICTs and palliative care teams working together could enable more people with end-stage non-cancer illnesses to die at home.
- intermediate care
- palliative care
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Contributors All authors (BL, SS, SR and LHH) had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.
Funding No funding was sourced for this piece of research. The sponsor of the study was the NHS Trust in which the authors work.
Competing interests BL, SS, SR and LHH have support from Northamptonshire Healthcare NHS Foundation Trust for the submitted work. BL, SS, SR and LHH have no relationships with Northamptonshire Healthcare NHS Foundation Trust that might have an interest in the submitted work, and their spouses, partners or children have no financial relationships that may be relevant to the submitted work. BL, SS, SR and LHH have no non-financial interests that may be relevant to the submitted work.
Ethics approval The study received ethical approval from the East Midlands Research Ethics Committee Nottingham (Ref. 15/EM/0600) on 18 February 2015.
Provenance and peer review Not commissioned; externally peer reviewed.